Ethanol may not be so good: Better hand hygiene for flu prevention

The American Society for Microbiology says rubbing hands with ethanol-based sanitizers should provide a formidable defense against infection from flu viruses, which can thrive and spread in saliva and mucus. But findings published this week in mSphere challenge that notion — and suggest that there’s room for improvement in this approach to hand hygiene.

The influenza A virus (IAV) remains infectious in wet mucus from infected patients, even after being exposed to an ethanol-based disinfectant (EBD) for two full minutes, report researchers at Kyoto Profectural University of Medicine, in Japan. Fully deactivating the virus, they found, required nearly four minutes of exposure to the EBD.

The secret to the viral survival was the thick consistency of sputum, the researchers found. The substance’s thick hydrogel structure kept the ethanol from reaching and deactivating the IAV. 

“The physical properties of mucus protect the virus from inactivation,” said physician and molecular gastroenterologist Ryohei Hirose, Ph.D, MD., who led the study with Takaaki Nakaya, PhD, an infectious disease researcher at the same school. “Until the mucus has completely dried, infectious IAV can remain on the hands and fingers, even after appropriate antiseptic hand rubbing.

The study suggests that a splash of hand sanitizer, quickly applied, isn’t sufficient to stop IAV. Health care providers should be particularly cautious: If they don’t adequately inactivate the virus between patients, they could enable its spread, Hirose said. 

The researchers first studied the physical properties of mucus and found — as they predicted — that ethanol spreads more slowly through the viscous substance than it does through saline. Then, in a clinical component, they analyzed sputum that had been collected from IAV-infected patients and dabbed on human fingers. (The goal, said Hirose, was to simulate situations in which medical staff could transmit the virus.) After two minutes of exposure to EBD, the IAV virus remained active in the mucus on the fingertips. By four minutes, however, the virus had been deactivated.

Previous studies have suggested that ethanol-based disinfectants, or EBDs, are effective against IAV. The new work challenges those conclusions. Hirose suspects he knows why: Most studies on EBDs test the disinfectants on mucus that has already dried. When he and his colleagues repeated their experiments using fully dried mucus, they found that hand rubbing inactivated the virus within 30 seconds. In addition, the fingertip test used by Hirose and his colleagues may not exactly replicate the effects of hand rubbing, which through convection might be more effective at spreading the EBD.
 For flu prevention, both the Centers for Disease Control and Prevention and the World Health Organization recommend hand hygiene practices that include using EBDs for 15-30 seconds. That’s not enough rubbing to prevent IAV transmission, said Hirose. 
 The study wasn’t all bad news: The researchers did identify a hand hygiene strategy that works, also sanctioned by the WHO and CDC. It’s simple: Wash hands, don’t just rub them. Washing hands with an antiseptic soap, they found, deactivated the virus within 30 seconds, regardless of whether the mucus remained wet or had dried. 

Food Safety Talk 176: Bug Book

The show opens with a discussion about privacy, whether you should cover the microphone on your computer, or how you can scare your kids using Alexa. The guys talked briefly about what they’re watching, Ben’s trip to Athens Georgia, and celebrity feet. From there the show moves into listener feedback talking about the safety of eating Canadian seaweed. Listener feedback makes a interesting segue into failure, and the things we can learn from it. The show returns to listener feedback with a discussion about citrus safety and infused water. For some reason Don wants to talk about smoke detectors, before returning again to listener feedback and “Contamination Corner”, and ways to learn about stuff you don’t know about (like filibusters). Ben and Don talk about an interview that Don did for Cooking Light, before Don wants to talk about fixing his broken software. Ben ends the show with a long discussion regarding safe cooking directions for frozen vegetables, and why no one can agree.

This episode is available at foodsafetytalk.com or on iTunes.

 

Show notes so you can follow along at home are below:

Trump gets his news here: Fox News host says he has not washed his hands in 10 years ‘Germs are not a real thing’

To the chagrin of his co-hosts, Fox and Friends presenter Pete Hegseth told the show’s audience Sunday morning that he hasn’t washed his hands in a decade.

Katherine Hignett of Newsweek writes the revelation came after co-hosts Ed Henry and Jedediah Bila questioned Hegseth’s off-camera consumption of pizza left out after National Pizza Day Saturday. Hegseth had argued that pizza “lasts for a long time.”

Bila then quipped Hegseth “might take a chomp out of” anything on a table “that’s not nailed down”—including mugs.

“My 2019 resolution is to say things on air that I say off air… I don’t think I’ve washed my hands for 10 years. Really, I don’t really wash my hands ever,” Hegseth continued, prompting laughter from his co-hosts.

“Someone help me,” Bila said. “Oh man.”

“I inoculate myself. Germs are not a real thing. I can’t see them. Therefore the’re not real,” Hegseth said.  

“So you’re becoming immune to all of the bacteria,” Bila replied, rolling her eyes. “My dad has that theory too.”

Hegseth later shared a Tweet in support of his unusual concept of health and hygiene with the hashtag “DontWash.”

But the Centers for Disease Control and Prevention states that handwashing is a vital way to prevent the transmission of disease. By washing your hands—especially after using the bathroom—you prevent the spread of harmful bacteria like Salmonella and E.coli that can persist in tiny, invisible particles of human feces

It’s also important to wash your hands after handling raw meat, as this can harbor germs leftover from animal feces.

“A single gram of human feces—which is about the weight of a paper clip—can contain one trillion germs,” the CDC reports.

Filion, K., KuKanich, K.S., Chapman, B., Hardigree, M.K., and Powell, D.A. 2011. Observation-based evaluation of hand hygiene practices and the effects of an intervention at a public hospital cafeteria. American Journal of Infection Control 39(6): 464-470.

Background

Hand hygiene is important before meals, especially in a hospital cafeteria where patrons may have had recent contact with infectious agents. Few interventions to improve hand hygiene have had measureable success. This study was designed to use a poster intervention to encourage hand hygiene among health care workers (HCWs) and hospital visitors (HVs) upon entry to a hospital cafeteria.

Methods

Over a 5-week period, a poster intervention with an accessible hand sanitizer unit was deployed to improve hand hygiene in a hospital cafeteria. The dependent variable observed was hand hygiene attempts. Study phases included a baseline, intervention, and follow-up phase, with each consisting of 3 randomized days of observation for 3 hours during lunch.

Results

During the 27 hours of observation, 5,551 participants were observed, and overall hand hygiene frequency was 4.79%. Hygiene attempts occurred more frequently by HCWs than HVs (P = .0008) and females than males (P = .0281). Hygiene attempts occurred more frequently after poster introduction than baseline (P = .0050), and this improvement was because of an increase in frequency of HV hand hygiene rather than HCW hand hygiene.

Conclusion

The poster intervention tool with easily accessible hand sanitizer can improve overall hand hygiene performance in a US hospital cafeteria.

Wilson, S.M., Jacob, C.J. and Powell, D.A. 2011. Behavior-change interventions to improve hand hygiene practice: A review. Critical Public Health 21: 119-127.

http://www.informaworld.com/smpp/content~content=a934338802~db=all~jumptype=rss

Despite the role of hand hygiene in preventing infectious disease, compliance remains low. Education and training are often cited as essential to developing and maintaining hand-hygiene compliance, but generally have not produced sustained improvements. Consequently, this literature review was conducted to identify alternative interventions for compelling change in hand-hygiene behavior. Of those, interventions employing social pressures have demonstrated varying influence on an individual’s behavior, while interventions that focus on organizational culture have demonstrated positive results. However, recent research indicates that handwashing is a ritualized behavior mainly performed for self-protection. Therefore, interventions that provoke emotive sensations (e.g., discomfort, disgust) or use social marketing may be the most effective.

277 sick from Noro: Carribean cruise from hell

CBS News reports one of the world’s biggest cruise ships, Royal Caribbean’s Oasis of the Seas, is returning to a Florida port a day early and giving passengers full refunds of their fare after 277 guests and crew members were hit with an outbreak of norovirus as it sailed to Jamaica.

Cruise line spokesman Owen Torres told The Associated Press, “We think the right thing to do is get everyone home early rather than have guests worry about their health.”

He says the ship will return to Port Canaveral on Saturday. It sailed from there Sunday on a seven-day Caribbean cruise.

Passengers took to social media on Wednesday, tweeting they were forced to stay onboard after docking in Falmouth, Jamaica, for what was supposed to be a day of excursions.

Torres said returning a day early gives the cruise line “more time to completely clean and sanitize the ship” before it sails again.

Food Safety Talk 166: Surprising lack of cannibalism questions

Don and Ben traveled to SUNY Geneseo for a live version of the podcast sponsored by the Center for Integrative Learning, and hosted by the amazing Beth McCoy. The episode title comes from an unrecorded after dark which may or may not have taken place in a bar in Geneseo.

Episode 166 is available on iTunes and here.

Show notes so you can follow along at home.

Party on: It’s Global Handwashing Day- October 15

Kids, kids. It’s global handwashing day.

Join CDC expert, Dr. Vincent Hill for a Facebook Live handwashing demonstration on October 15 at 11:00 AM EDT in observance of Global Handwashing Day. Global Handwashing Day is an occasion to support a global and local culture of handwashing with soap, and promote handwashing with soap as an easy and affordable way to prevent disease in communities around the world.

The Facebook Live presentation will feature a handwashing contest between two volunteers to help viewers understand the importance of proper handwashing techniques. Tune in via CDC Facebook at www.facebook.com/cdcgov

I don’t do hashtags.

Do you really have to wash your hands every time you use the bathroom? The definitive answer, according to Schaffner

Following on all things Schaffner, a professor of food science at Rutgers, who has been studying hand washing for years and says the conventional wisdom shouldn’t be ignored.

“It doesn’t matter whether you’re peeing or you’re pooping, you should wash your hands,” he told Business Insider.

Here’s why.

Germs can hang out in bathrooms for a long time

Each trip to the restroom is its own unique journey into germ land. So some occasions probably require more washing up than others.

“If you’ve got diarrhea all over your hands, it’s way more important that you wash your hands than if… you didn’t get any obvious poop on your fingers,” Schaffner said. “My gosh, if you’ve got poop on your hands and you have the time, certainly, get in there, lather up real good and do a real good job.”

Compared to feces, urine can be pretty clean when we’re not harboring any infections, though it’s not totally sterile.

“People who use urinals probably think they don’t need to wash their hands,” Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said to the New York Times. (In studies, women tend to be better about adhering to hand washing than men.)

But it’s best to wash your hands after every trip to the toilet because human feces carry pathogens like E. coli, Shigella, Streptococcus, hepatitis A and E, and more.

You can also easily catch norovirus by touching bathroom surfaces that have been contaminated with a sick person’s poo or vomit, then putting your hands into your mouth. The super-contagious illness is the most common food poisoning culprit, and causes diarrhea, vomiting, nausea and stomach pain.

wide variety of other microbes and bacteria can be found in bathrooms, too. Some strains of Staphylococcus, or staph, are “found on almost every hand,” as a team of hand washing researchers pointed out in a 2004 study. Public toilets can house many different drug-resistant strains of that bacteria.

“I think a good general rule of thumb is you should wash your hands any time you feel that they might be dirty,” Schaffner said. In other words, seize the opportunity when you’re near a sink.

He said he’s not “super paranoid” about making sure his own hands are always squeaky clean, but some of his favorite times of day to wash up are after walking the dog, working in the dirt, or handling raw meat.

Even a quick “splash ‘n dash,” as researchers like to call the practice of rinsing with water but no soap, can help fight off some bacteria that causes infections. But that shortcut is not advised if you might have raw meat or feces on your mitts, and a lather with soap and water is more effective at disinfecting hands than any wipe or sanitizer.

Here are Schaffner’s best tips for your next journey to the toilet

Follow this simple, three-step hand-washing plan to lower your chances of getting colds, self-inflicted food poisoning, and diarrhea.

First, don’t worry about the temperature of the water; Schaffner’s studies have confirmed that doesn’t make a difference. He suggests that you “adjust the water temperature so it’s a nice comfortable temperature, so you can do a good job.”

Second, give yourself enough time to “get some soap in there, lather it up real good, clean under your finger nails,” Schaffner said. Spending even five seconds washing your hands can help reduce the amount of bacteria on them, but 20 seconds is better. The Centers for Disease Control recommends humming the Happy Birthday song to yourself twice as a timer.

Third, dry off before you leave the room. This step is key because wet hands transfer more bacteria than dry ones.

“If your hands are still wet, you go to touch that door of the bathroom, having your wet hand might actually help transfer bacteria,” Schaffner said. He’ll even dry his palms on his pants if there’s no paper towel around.

Despite all the evidence demonstrating the health benefits of regular hand washing, Schaffner knows his advice can only go so far.

“I’m not in charge of you washing your hands, just because I’m a guy who did some science and did some research on hand-washing,” he said. “You do what you want.”

Well said.

We ain’t preachers, just provide evidence-based advice.

Got me a job at Kansas State University, got me dismissed.

This is a handwashing sign

The Moose Cree First Nation (formerly known as Moose Factory Band of Indians) is a Cree First Nation band government in northern Ontario, Canada. Their traditional territory is on the west side of James Bay. The nation has two reservesFactory Island 1 (the northern two-thirds of Moose Factory Island); and Moose Factory 68, a tract of land about 15 km upstream on the Moose River covering 168.82 square kilometres (65.18 sq mi).[

My friend, who has been canoeing down the Moose River for the last week found this in the restaurant at Moose Factory (you aren’t Canadian unless you know how to make love, or just have sex, in a canoe).

Food Safety Talk 162: FST Bolo Ties

The show opens with a bit of discussion about other podcasts, but quickly moves to the main subject at hand: a recent study on the increased isopropanol tolerance of certain bacteria found in hospitals.  The guys weigh in on the strengths and weaknesses of the study, including it’s relevance to food safety, with some help via listener feedback. The next topic is Chipotle’s recent problem with Clostridium perfringens in their beans. The guys introduce a new segment on Canadian foods, before moving to listener feedback on fermented foods, CSPI, and thermometer calibration, times and temperatures, food dehydrators, handwashing, and double gloving. The show ends with a discussion of a recent cookbook recall.

Episode 162 is available on iTunes and here.

Show notes so you can follow along at home:

Using observation to evaluate training: Canadian High School edition

A couple of old friends Shannon Majowicz and Ken Diplock and colleagues from Waterloo, (that’s in Canada) are doing good work looking at food safety stuff with high school students- evaluating training efficacy using observation. They published their work demonstrating some sustained food safety behaviors following a training program, this month in the Journal of Food Protection.

Kenneth J. Diplock, Joel A. Dubin, Scott T. Leatherdale, David Hammond, Andria Jones-Bitton, and Shannon E. Majowicz. 2018. Observation of High School Students’ Food Handling Behaviors: Do They Improve following a Food Safety Education Intervention?

Greenbank High School Birkdale Merseyside.

Journal of Food Protection: June 2018, Vol. 81, No. 6, pp. 917-925

Youth are a key audience for food safety education. They often engage in risky food handling behaviors, prepare food for others, and have limited experience and knowledge of safe food handling practices. Our goal was to investigate the effectiveness of an existing food handler training program for improving safe food handling behaviors among high school students in Ontario, Canada. However, because no schools agreed to provide control groups, we evaluated whether behaviors changed following delivery of the intervention program and whether changes were sustained over the school term. We measured 32 food safety behaviors, before the intervention and at 2-week and 3-month follow-up evaluations by in-person observations of students (n = 119) enrolled in grade 10 and 12 Food and Nutrition classes (n = 8) and who individually prepared recipes. We examined within-student changes in behaviors across the three time points, using mixed effects regression models to model trends in the total food handling score (of a possible 32 behaviors) and subscores for “clean” (17 behaviors), “separate” (14 behaviors), and “cook” (1 behavior), adjusting for student characteristics. At baseline, students (n = 108) averaged 49.1% (15.7 of 32 behaviors; standard deviation = 5.8) correct food handling behaviors, and only 5.5% (6) of the 108 students used a food thermometer to check the doneness of the chicken (the “cook” behavior). All four behavior score types increased significantly ∼2 weeks postintervention and remained unchanged ∼3 months later. Student characteristics (e.g., having taken a prior food handling course) were not significant predictors of the total number of correctly performed food handling behaviors or of the “clean” or “separate” behaviors, and frequency of cooking and self-described cooking ability were the only characteristics significantly associated with food thermometer use (i.e., “cook”). Despite the significant increase in correct behaviors, students continued to use risky practices postintervention, suggesting that the risk of foodborne disease remained.